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Annual Oration of 1894

Problems in State Medicine

Orator: E. V. Scribner, M.D.

Synopsis of Oration:

Dr. Scribner briefly chronicles the history of society's response to mental illness. He tells of the first hospital devoted specifically to psychiatric patients in the 5th century A.D., moves through the torture and execution of the insane in the 16th century, and then lists the earliest psychiatric hospitals in the United States. He focuses on the Worcester Hospital as illustrative of the general attitude toward the mentally insane. Apart from the idea that a jail-like atmosphere was the only appropriate means of dealing with these patients, many believed that a high recovery rate could be achieved, but their claims were not validated. Scribner regrets the fact that states have not kept up the rate of asylum-building to match the number of patients, leading to overcrowding in the current institutions. The doctor provides statistics that call attention to the fact that the population of mentally ill is increasing much faster than the general population.

He also speaks about the deplorable treatment many institutionalized psychiatric patients receive. Scribner suggests that institutionalization is not always necessary for effective psychiatric treatment, a very progressive idea considering the recently morbid views of mental illness. He emphasizes the unique attitude that must be adopted by those who work with these patients, as they require gentleness and moral guidance more than their mentally competent counterparts. The doctor proposes that the "dependent insane" are the State's responsibility and that its assuming this duty would even out community financial burdens. He calls on his colleagues to aid the progression, already in motion, of considering mental illness a clinical disease rather than a character flaw. He also stresses the necessity of mental illness instruction as a part of medical school curricula.

Scribner shifts to a short overview of the epidemiology/etiology of mental illness. He notes that heredity has been cited as a strong indication of mental illness. Among other purported causes are the intoxicated state of the parents at conception and educational pressure, especially followed by forced physical education.

Dr. Scribner's talk presents current views of mental illness as advanced compared to those of only a few decades prior. His proposals for improvement are based on progressive ideas. His alarming statistics effectively convey the urgency of expanding metal illness treatment facilities. While Scribner has a serious agenda to relay, he concludes on a hopeful note, claiming that if his suggestions are followed and attitudes toward mental illness continue to become more liberal, the field of mental illness will reach the advanced state he envisions.


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